Hamstring Tendonitis is a problematic physical issue for athletes and athletic types, and a potentially career ending issue for semi-pro and professional athletes.
Tendonitis of the hamstrings is also one of the tougher tendonitis dynamics to figure out and fix because generally hamstring tendinitis is a -symptom- of structural and bio-mechanical issues like the pelvic bones (hips) being out of alignment.
Wrist Tendonitis, for instance, we can easily deal with online. Hamstring issues, maybe, maybe not. Let's get to work and see what there is to see.
What is Hamstring Tendonitis?
What is Hamstring Tendonitis?
First off, know that tendonitis is a -dynamic-. It's not just an isolated problem with a hamstring tendon. There are many factors involved.
See: What Is Tendonitis
So if you think you have tendonitis of a hamstring tendon, you really have a 'problem' that's bigger than just the tendon.
And you definitely need to understand the Pain Causing Dynamic.
Notice that I didn't call that headline 'The Hamstring Tendons'.
Why? Because the hamstring consists of muscle, tendon, and tons of connective tissue interweaving the whole thing and connecting to everything.
Imagine a sponge, half squeezed, and then tightly wrapped in saran wrap. It's a LOT like that.
The hamstrings are long, strong muscles that turn into tendon at the ends, that connect below the knee and onto the pelvic bones.
The muscle contracts and pulls those two points of connection together. Over and over and over.
Every time a muscle contracts, when it relaxes it retains a little tiny bit of that contraction. So things get tighter over time.
That constant tightness does two things:
1. Puts CONSTANT tension on the tendons
2. The tighter a muscle is, the less able it is to do it's job which is to perform work and absorb force.
Hamstring Tendonitis is a dynamic where muscles are too tight and have been too tight over time, connective tissue too shrunkwrapped and constrictive, a Process of Inflammation is in place, the nervous system gets freaked out goes too far in the defense mode direction, and there is some amount of nutritional insufficiency/deficiency.
See: Magnesium for Tendonitis
Tendonitis is often called a Repetitive Strain Injury, or Repetitive Motion Injury, or Repetitive Stress, or Repetitive Use.
The repetition isn't really the problem. The problem is that the farther a muscles structure is from 'optimal', the less able it is to happily do it's job.
And when it can't do it's job, it starts to hurt.
There Are Two Types Of Tendonitis....with damage, and without damage. Yes, you can hurt, even have debilitating tendon pain even without any damage at all.
Do I Have Hamstring Tendonitis Or
An Actual Hamstring Tendon Injury?
You either have an irritated muscle and tendon scenario, or you have an injured tendon, meaning there is actual rip or tear.
Even in an irritation scenario, there is microscopic wear and tear. But it's SO small, and even if there's scar tissue laying down, that's a minor issue. That scar tissue is just a symptom, it's not a cause.
Again, you either have irritation, or you have actual rip and tear.
Here's the thing. Even if there's rip or tear, you STILL have, and almost certainly had, all the other factors that are involved with Tendonitis, meaning, too tight muscle, too tight connective tissue, nutriitonal deficiency, over protective nervous system.
The case can be made that you wouldn't have gotten a hamstring tendon tear if your muscles hadn't been too tight, connective tissue too tight, etc.
Remember, the tighter a muscle is, the less able it is to fire optimally, which means it can't absorb force like it's supposed to, which means that force still has to go -somewhere-....which is where the tear happens.
The problem is, unless it's a major rip in the hamstring tendon (and even then), it can be tough to tell the difference between irritation and injury.
Anytime it hurts, we call it an injury, that's just the way our culture works.
But it's HIGHLY possible that even with severe pain, there is no actual injury. It's just VERY irritated and irritable.
Hamstring Tendon Injury
A hamstring tendon injury consists of an actual, significant tear.
If the tear is (approximately) 5% or less, we call it a 'Muscle Pull'. See: Pulled Muscle Symptoms
More than that, and you're in the realm of getting an MRI to see the extent of the tear.
** NOTE: Don't bother getting an xray. Or at least, if a doctor wants to do an xray, that's fine as long as an MRI is done too. Xrays are really only good for looking at bones. To see a tendon tear the tendon has to be a big one and the tear has to be BIG.
If you're NOT an athlete, you're probably fine with a 40% or smaller tear. It'll hurt for a good long while, and you'll always have issue with that muscle being extra too tight, but if you're not an athlete or have an athletic job, it's really not that big a deal.
If you are an athlete or have an athletic job, then an up to about a 40% tear you MAY be able to get away without surgery. IF you treat it diligently and intelligently.
Tears over 50% you generally most certainly do want reattachment surgery.
Having said that, if it's not a total tear, I'd DEFINITELY consider The ARPwave System. It will not only heal the tear faster than seems possible, but it will also clear out all the compensation pattern etc that led to the tear in the first place.
In my humble opinion, the ARPwave is a FAR superior treatment for hamstring tendonitis and hamstring tendon tear than surgery ever possibly could be.
If only because surgery causes damage and injury. And then they immobilize you for weeks....which is not good.
So you don't have a big tear, but you have all sorts of pain and problem in the hamstrings. Maybe even hamstring tendon pain.
So you have a tendonitis -dynamic-. Muscle is too tight, connective tissue too tight, constant tension on the tendons and associated connective tissue, etc.
Maybe you even have some wear and tear on the tendon and thus scar tissue build up.
Here's the thing: Even if it hurts, the tendon is NOT the issue. The CAUSE of the problem is not the tendon, it's the muscle and connective tissue. You can treat the tendon all day long but if you don't deal with the chronic tightness etc, nothing is really going to change.
The 'fix' for hamstring tendonitis is NOT in treating the tendons.
How To Treat Hamstring Tendonitis
Rest will NEVER fix hamstring tendonitis.
Anti-inflammatory drugs like Ibuprofen are fine to get you through the day, but are not a fix in any way.
Same thing with Corticosteroid Injections. They -may- lower pain levels, but they don't actually make anything 'better'. If they do reduce pain, you're generally going to go use the legs more, and cause more problem.
If you go to the PT (because that's where doctors will send you) you'll be doing stretching and strengthening, ultrasound, hot and maybe cold packs.
I've yet to hear a person say 'Ultrasound really helped!'. Ultrasound sounds good in theory, but....
Heat is great. It brings new blood to the area, which helps things feel better temporarily. But due to the inflammation process, fluid gets trapped in the area. And heat doesn't beat inflammation.
Ice packs are fine, they cause circulation and reduce pain levels. But cold packs for 20 minutes a pop are only so effective.
The Flaw of Stretching and Strengthening
While stretching and strengthening exercises for both the hamstrings and the quads are valuable and everybody should do them, stretching and strengthening as a hamstring tendonitis treatment has a few fatal flaws.
First off, strength isn't the problem. You don't have hamstring tendonitis symptoms because your hamstrings are weak. There are a few cases where that is the problem, don't get me wrong, but for the fast majority of cases, weak muscles aren't the problem.
Stretching is fine, except that what's flexible flexes, and what's not flexible doesn't. So parts of a muscle that are 'stuck', aren't really going to stretch, they'll just get pulled on and they generally don't like that.
Stretching isn't very targeted to the specific tightness that needs to get opened up.
Treating Hamstring Tendonitis Successfully
To effectively get rid of hamstring tendonitis, you have to -reverse- the progressive dynamic.
You have to loosen up and soften up chronically tight muscles. Muscles really aren't 'too tight'. They are constantly firing, constantly contracting, and are thus 'too short'.
You have to loosen up and soften too tight, clamped down connective tissue. Open up that constrictive saran wrap tightly wound around the half squeezed sponge of the muscle.
You have to get rid of the inflammation process. See: How To Reduce Inflammation
You have to fill up any nutritional insufficiency.
Did you know that Vitamin D deficiency can cause muscle pain that mimics tendonitis symptoms? Yep.
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